Quality of life and comorbidities in hypertensive patients

Abstract

Introduction: An important factor influencing the perception of health‑related quality of life (HRQoL) is the presence of chronic diseases, especially polymorbidity. Comorbidities in hypertensive patients have been observed to reduce the effect of therapy and to decrease the HRQoL. Although the effect of comorbidities on the HRQoL in hypertensive patients is becoming apparent, only few studies have investigated this relationship in details. The primary aim of the study was to assess the relationshipbetween comorbidities and different aspects of HRQoL in patients undergoing treatment for hypertension. Patients and Methods: A questionnaire-based study was conducted in a group of 50 unselected patients treated of hypertension. To assess the 10-year survival rate in patients with several comorbidities, we used the Charlson Comorbidity Index (CCI) scoring system. HRQoL was evaluated using the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12). Results: The study group consisted of 29 men (58%) and 21 women (42%), having the mean age of 63,5 ± 8,7 years. Coexisting diseases were reported in 47 patients (94%), including dyslipidemia (20,8%), coronary artery disease (CAD; 19,8%), COPD (10,9%) diabetes (9,4%) and myocardial infarction (8,3%). The average of 10 years survival rate, according to CCI represents 77,5% and 42,3% for age related CCI. The correlation analysis between hypertension levels and physical functioning revealed a weak, negative association (r=-0,2). There is a strong, positive association between CCI and physical functioning as a dimension of HRQoL (r=0,73), meaning that 53% out of the physical functioning is determined by the comorbidity index variation. Also, the correlation analysis sugests a moderate, positive association between mental health and CCI (r=0,58), resulting that 34% of mental health as a dimension of HRQoL depends on comorbidity index variation. Women reported higher HRQoL in both dimensions assessed by the SF‑12 form: physical functioning (43,2% vs. 40,7%) and mental health (46,4% vs. 44,7%).Conclusions: Chronic diseases concomitant with arterial hypertension affect negatively all of the HRQoL dimensions. The presence of complications and comorbidities influences the HRQoL in hypertensive patients more than hypertension itself. These findings suggest that prevention, early diagnosis and effective treatment of chronic diseases are important to preserve the HRQoL in patients with hypertension.